Evaluation of the Temporal Profile of Primary Headaches.

Radha, M (2009) Evaluation of the Temporal Profile of Primary Headaches. Masters thesis, Madras Medical College, Chennai.


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Headache is the most common complaint of civilized human species world wide. It has the dubious distinction of being the earliest recognized symptom of a wide spectrum of diseases. Headache has been referred to in many ancient literatures. The earliest reference dates back to a papyrus (ancient medical text book) as old as 3500 BC in the tomb of Thebes that mentions the king in the tomb had sufferred all his life of a sickness of half head. A poem recovered from a Babylonian ruin written in Sumeria in 3000BC roughly translates as The sick eyed says not……. I am sick eyed….. The sick headed not ……. I am sick headed… Hippocrates (460-377BC) wrote a description of a disease of the hemicrania that relieved on vomiting. This work of dissertation has been done with an aim at documenting the different types of headache, their clinical presentations, diagnostic modalities and responses to prophylaxis, who presented to the Headache clinic of Institute of Neurology, Government General Hospital, Chennai during a one year period. The observations of this study are here with summarised 1. Migraine is the commonest type of headache comprising of about 75%. Migraine without aura [48%] was more common than migraine with aura [32%]. Female preponderance was noticed in all subtypes of migraine, age of onset being in 2nd and 3rd decade for majority of the subgroups of migraine, except for basilar migraine which was common in 1st and 2nd decade. 2. Chronic migraine, Migraine triggered seizures and Migrainous infarction were the complications of migraine encountered in this study in the order of frequency of occurrence. Transformation to Chronic migraine was more common from episodic forms and in patients with onset of migraine in teens or twenties. Migrainous infarction was seen only in female patients who had exclusively migraine with aura and all the five patients had posterior circulation strokes. 3. 14 patients were grouped as migraine triggered seizures. These patients differed from the classical description of migralepsy in their duration of headache, with a window period of more than three hours prior to the seizure. This group of patients presented with both migraine with aura and migraine without aura and responded to anti-migrainous prophylaxis alone with a 1 year episode free period. 4. Mean Heart Rate shows difference between the control and migraine patients but is within physiological range and no variation was observed in power spectral analysis. 5. Patients with migraine with and without aura responded well to beta blocker at lower dosages with headache free interval of more than six months in majority. Patients with basilar migraine benefited from either propronolal or flunarizine, but patients with chronic migraine responded predominantly to combination prophylaxis. 6. Patients with tension type headache responded to amitriptyline and those patients with tension vascular headache i.e. patients with features of tension type headache and of migraine responded well to a combination of beta blocker and amitryptyline.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Temporal Profile ; Primary Headaches.
Subjects: MEDICAL > Neurology
Depositing User: Kambaraman B
Date Deposited: 28 Jun 2017 11:25
Last Modified: 28 Jun 2017 11:25
URI: http://repository-tnmgrmu.ac.in/id/eprint/571

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